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Tuesday, May 1, 2012

Young People and Cancer

by Victor Bernhartz

Cancer
is a group of some 200 diseases all involving unregulated cell
growth. The existence of has been known for over four millennia,
although the more sophisticate understanding of cancer enters in the
second half of the 19th
century. Roughly 90 per cent of cancer is caused by environmental
factors, i.e. are not caused by inherently genetic faults. However,
in the individual case, it is very difficult to establish the exact
cause of a specific disease and it’s history in the body, before
discovery and treatment.

Being
a young adult patient and survivorCancer
is indeed lethal. Discussing cancer always means, on one level or the
other, a discussion about death. While death is a topic not
uncommonly brooded on in adolescence, living with cancer as young
person involves a very direct meeting with said brooding.

There
is no way to describe how young people with cancer generally think
and react to the disease. Consider being the centre of attention in
class or in a circle of friends, while no one can be expected to have
a deeper understanding of the disease, combined with their fear of a
condition you have learned to fear. How one deals with that
individually varies greatly. The common denominator being that life
indeed changes radically.

Some
friends will disappear, from fear or from not knowing what to do –
or from the fact that cancer is a full-time position. In between
tiring treatment sessions at clinics and dealing with issues related
to the illness, there isn’t much time for social life. Young
friends cannot be expected to understand, but nonetheless, remaining
a close friend to a young person living with cancer, will require a
lot. Being close to a cancer patient means placing many (if not most)
of your personal priorities on hold. Adapting to that requires
determination and patience as well as a lot of love.

With
regards to family and the closer circle of relatives, a young
person’s cancer will undoubtedly pull everyone in, regardless of
reaction. Making sure the young person is supported emotionally and
logistically will occupy most of the family’s time. Sometimes, the
practicalities will make you forget that all arrangements are due to
a potentially lethal condition – an absurd situation is normalized
and integrated in the regular day, affecting work, studies and social
patterns.

Many
young survivors will carry traces from successful cancer management
for the rest of their lives. Two out of three childhood cancer
survivors experience at least one complication in therapy, and one in
three develop complications that might require treatment later in
life. Transition into adulthood is also altered. Time away from
regular life means time away from education and work experience, as
well as opportunities to socially grow, with friends and lovers.
Fertility can be affected by therapy, and the future risk of
developing another cancer is higher. Hence, coming out of cancer
management as a survivor does not mean that things will go back to
“normal”. Young patients are at greater risk of future
complications compared to adult patients, simply because young people
have a longer stretch of life ahead of them, in which things could go
wrong.

The
1970s and talk therapyCancer
was, up until the appearance of AIDS, the paradigmatic disease of the
20th
century. Despite continuous scientific progress, it was a condition
(in much similarity to AIDS) associated with stigma. Furthermore, it
was associated with personal characteristics and attitudes,
specifically in the 1970’s, when the alternative treatment “talk
therapy” emerged.

Personal
attitudes towards life and patient’s psychology were basis in such
treatment. You could have a “cancer personality”, meaning you
were depressed or self-loathing. To live through the disease, one was
supposed to “fight cancer”. The road to be free of cancer was to
be happy. So-called “positive thinking”, still a popular element
in 21st
century discourses on cancer (with breast cancer as an outstanding
example), emerges here. More on this can be found in Susan Sontag’s
Illness as Metaphor
(1978).

More
conventional medical cancer management, such as surgery and
chemotherapy, was available in the 1970s. In the US, president
Richard Nixon declared a “war on cancer” in 1971. Some argue that
such radical wording paves the way for destructive management
methods, as well as placing responsibility for a recovery with the
individual patient.

For
the purpose of the larp, talk therapy, positive thinking and the war
on cancer should provide entry points for players. Were they involved
in talk therapy or not? How do they relate to the criticism of talk
therapy and to the president’s war? And following that, does the
above affect their reactions to AIDS and people living with the
disease?